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See a sample rate comparisonCPT 33420 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Heart Valve Surgery, Surgery To Open The Heart Valve (Mitral) That Moves Blood Between The Left Upper And Lower Heart Chambers. Scar Tissue Or Inflammation Has Closed The Valve. The Stuck Tissue Is Cut Apart Or Separated By Progressive Dilation (Manually Widening The Opening).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Cardiovascular System |
| Common Place of Service | 11 - Office 21 - Inpatient Hospital |
| Common Modifiers | UD GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | $1,387.14 national non-facility rate (2026) · View Medicare rates for 33420 |
| Medicaid Fee Schedule | $1,087.06 median of the 8 states in the free preview · View Medicaid rates for 33420 |
National average reimbursement for CPT 33420 by major payers:
$1,806.81
$1,966.61
$2,066.86
$2,306.48
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CPT 33420
5 of 25 sample ratesHigher to lower in this preview
Alaska Surgery Center, Limited Partnership
Alaska Surgery Center Limited Partnership
$4,115.00Published rateMidland Texas Surgical Center, LLC, Texas Surgical Center, An Affiliate Of Midland Memorial Hospital
$1,049.00Published ratePhysicians Surgery Center At Glendale Adventist, LLC
Physicians Surgery Center At Glendale Adventist LLC
$700.00Published rateChristus Santa Rosa Pasc-San Antonio LLC, Christus Santa Rosa Physicians Ambulatory Surgery Center-Stone Oak
Christus Srpasc - San Antonio, LLC
$501.00Published rateEastside Surgery Center, LLC
Painmds Ambulatory Surgical Center LLC
$105.00Published rate
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See a sample payer proposalCPT 33420 vs. Other Surgical Procedures on the Cardiovascular System Codes
The CPT 33420 code is part of the Surgery services used for Surgical Procedures on the Cardiovascular System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 33420 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 33418-CPT | High | Transcatheter Mitral Valve Rep, Transcatheter Mitral Valve Repair Percutaneous Approach Including Transseptal Puncture When Performed Initial Prosthesis |
| 33419-CPT | Moderate | Repair Tcat Mitral Valve, Transcatheter Mitral Valve Repair Percutaneous Approach Including Transseptal Puncture When Performed Additional Prosthesis Es During Same Session List Separately In Addition To Code For Primary Procedure |
| 33420-CPT | High | Heart Valve Surgery, Surgery To Open The Heart Valve (Mitral) That Moves Blood Between The Left Upper And Lower Heart Chambers. Scar Tissue Or Inflammation Has Closed The Valve. The Stuck Tissue Is Cut Apart Or Separated By Progressive Dilation (Manually Widening The Opening). |
| 33422-CPT | High | Heart Valve Surgery, Surgery To Open The Heart Valve (Mitral) That Moves Blood Between The Left Upper And Lower Heart Chambers. Scar Tissue Or Inflammation Has Closed The Valve. The Stuck Tissue Is Cut Apart Or Separated By Progressive Dilation (Manually Widening The Opening). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 33420. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 33420 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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